2012 Recap and a Look Ahead to 2013

Here’s the link to my post over at FFLockerRoom.com, recapping the 2012 season and taking a look at how some key injuries will effect 2013.

http://fflockerroom.com/2013/02/05/the-season-that-was/

Enjoy!!

Super Bowl Injury Report and Prediction

Well, the last game of the 2012-13 season is officially upon us and, to be quite honest, I couldn’t be more disgusted with the outcome (I take that back. If you’d have replaced the 49ers with the Giants, then I’d probably boycott the game altogether). The stench of the Patriots performance in the AFC championship two weeks ago has already worn off now that I’ve had time to realize that the better and hotter team definitely won that game. However, there’s just a little something about the Ravens that I dislike, almost as if their hatred for all things Patriots has crossed over into an irrational zone, as if they hate the Patriots because they’ve convinced themselves that they have to. But one positive that’s come out of this most recent Pats-Ravens battle is that it feels like rivalries are slowly beginning to creep back into the NFL, something we haven’t had quite as much over the last decade.

While we’ve had Brady-Manning and Ravens-Steelers over the last decade, both of those rivalries are more natural in nature, with the 2 best QBs at the time facing each other every year and the Ravens and Steelers being division foes. This Pats-Ravens rivalry is a bit different in that it’s developed strictly based on their regular season and playoff meetings, with no other correlation between the two teams. And with Ed Reed speaking to the media yesterday about entertaining the idea of playing for the Pats next year, this rivalry may just be beginning to spread its wings.

Now on to the big game. Let’s take a quick look at each team and touch on some key or nagging injuries that could play a role on the outcome of the game.

Baltimore Ravens:

Dannell Ellerbe (P): There shouldn’t be much limitation Sunday, as he was able to play in the AFC Championship without looking too hindered by his sprained ankle. He was quoted at media day saying that there’s no way he doesn’t play and that if he played in the AFC Championship, it means he’s playing in the Super Bowl. By all accounts, it appears to be a relatively mild to moderate ankle sprain, more of the garden variety than anything to be overly concerned about. I’d expect he’s received a ton of treatment on it over the last two weeks and having that extra week off more than likely did wonders for the irritability levels he may have had otherwise. And with any inflammatory condition (like a sprain), rest is typically the most important and hardest thing to come by, which he’s had more than enough time for this past 1 1/2 weeks. I’d expect him to be pretty close to a full go on Sunday.

Ed Reed (P): He’s had chronic shoulder and neck issues, with the shoulder being more of the issue at this point. But it seems that calling it an “issue” is overstating it. He’s an older player who’s earned the right to rest and sit out practices in an effort to keep him as fresh as possible. There are no indications whatsoever that he’s even limited by this in the slightest. Expect him to be 100% on Sunday, or as close to 100% as a 34 year old safety in his 11th season can be.

Dennis Pitta (P): Listed as having a “thigh” injury, this usually indicates that it’s either a thigh contusion or a quadriceps strain, either of which would require rest/soft tissue mobilization/stretching/modalities to help decrease the flare up. It’s essentially all about limiting inflammation within the tissue so that the muscle/joint can function as optimally as possible. The days off he was given last week are more precautionary than anything else, a luxury at this point of the season. In Pitta’s case, I wouldn’t expect this to limit him too much and think he’ll be just fine come Super Bowl Sunday.

Ray Lewis (P): Well, he’s got his deer and antler juice, so he’s good to go right? (j/k) (kind of). In all seriousness, him and Justin Smith (see below) are basically in the same boat. The bracing they wear is what allows them to continue to play at a high level. Without the bracing, I can’t see a scenario where Lewis or Smith play the way they’ve been playing. Both guys will have surgery in the offseason, at which point they should make pretty healthy recoveries. For this game in particular, expect Lewis to be just fine, using the last few games as a guideline for what to expect. And if he takes a shot of deer juice prior to the game, he’ll be EVEN better.

San Francisco 49ers:

Aldon Smith (P): No worries about his shoulder, as he returned to practice Wednesday and is in no danger of missing the biggest game of his career. He’s had a few nagging injuries in the last few weeks, but seems to be more limited by whether Justin Smith is out there or not rather than his own injuries. No worries on the injury front here.

Ahmad Brooks (P): He was diagnosed with a grade 1 AC joint sprain, which is a sprain of the very end of the collar bone and the bony prominence on the end of the scapula. The good thing about this diagnosis is the “grade 1” part of things, which means it’s just a mild sprain without too much damage to the ligaments that hold the joints together (Remember, sprains happen to ligaments, strains happen to muscles). He’s gotten treatment on it the last two weeks and returned in a limited fashion to practice on Wednesday. This shouldn’t limit him much at all for Sunday’s contest.

Justin Smith (P): Let’s start off by saying he’s not 100% and he’s playing. Ok, now that that’s out of the way, just know that the bracing he wears around his injured elbow does basically two things: 1, it protects the triceps muscle that’s torn from going into ranges of motion that place the most strain on it, essentially locking it into a safe range of motion. 2, it provides stability to the elbow joint to allow it to take on force without worrying about instability. So he will continue to wear the brace and continue to play at a pretty high level, which solidifies the 49ers’ D-line immensely.

49ers (-3.5) vs Ravens:

So now that the injury news is out of the way, how is the game going to play out? In all honesty, this is a tough game to call because we have one team that’s been consistently great all season long (49ers) and one team that’s just on a roll right now (Ravens). Throw in the fact that Colin Kaepernick has 9 games of video to scout in the NFL and that no one has shown the ability to slow down this Pistol offense AND with the Ray-Lewis-Is-Retiring hoopla, it really is difficult to predict what’s going to happen. How do I see it playing out?

I think the big storyline on the field is how the older, slower Ravens D will try to stop the running QB and dominant running game of the 49ers. The Ravens have a unique way of modifying their defensive schemes to whoever they’re playing, regardless of the style of play. They’ve beat two dominant QBs in back to back games and do a great job of limiting big plays down the field. But they’ve played only 1 game this year against a running QB (12/9/12) against the Redskins and RGIII, at which point they were beaten in OT after RGIII left the game with his now-infamous knee injury. My sign of how a team handles a running QB is how that defense handled the running back. If the running back goes off, it shows that the D may be either putting way too much focus on stopping the QB of a read-0ption offense or they just can’t stop the run altogether. Alfred Morris ran for 129 yards and a TD that day, which bodes well for Frank Gore, LaMichael James, and the 49ers running attack. Granted, the Ravens weren’t very good stopping the run all season, but again, when a team is very hot like the Ravens are, all numbers get thrown out the window. But I do see Kaepernick and the 49ers’ rushing attacking having a good day against this slower Ravens D.

On the other side of the ball, the Ravens must do a good job of establishing a running game early on or else Joe Flacco’s deep ball off a play fake won’t do any damage. I think the Ravens have a big enough O-line to have some success against the Niners, but the 49ers’ front seven is as good as it gets, so it won’t come easy. I think Flacco will have a solid game based on the fact that he’s just be unstoppable these days and seems to be really hitting his stride, so I won’t bet against him having a good game Sunday.

So what happens? I see the Ravens being overwhelmed athletically early on with the dynamic 49ers offense, falling behind and abandoning the running game, and putting the entire game on Flacco’s shoulders. And although I see Flacco throwing a couple TDs and moving the ball well downfield, I also see him doing one thing that he’s not done at all this postseason: Turn the ball over. I think he throws 1-2 INTs against this opportunistic 49ers defense, which will be the deciding factor in the 4th quarter. Final score: 49ers 27, Ravens 21

And now a couple fun predictions:

Coin flip: Heads

1st scoring play: David Akers field goal

Longest play of the game: >40 yard pass to Michael Crabtree

MVP: Colin Kaepernick

Enjoy the game folks!! Go Pats!! (oh, wait, you’re saying they’re not there this year? ya, nevermind then)

Championship Round Preview

Well, boys and girls, Championship weekend is upon us and we have a couple of very intriguing match ups. As you all know, I’m a huge fan of the Pats, and I couldn’t be more freaked out by an AFC championship matchup than I am now. I actually was pulling for the Broncos to win their divisional round game because I felt the Pats matched up much better against the Broncos D. Now, facing Joe Flacco and not Peyton Manning is definitely a plus, but Flacco is playing so well in the playoffs that I almost feel like he’s the hottest QB in the NFL right now. Both teams are relatively healthy considering the time of the year, with the exception of the Pats not having Rob Gronkowski and possibly Danny Woodhead. Let’s take a look at the injury situation for the AFC Championship:

Patriots (-8) vs Ravens: As I mentioned above, Woodhead suffered a sprained thumb in the Divisional round against the Texans. He’s officially listed as probable, and based on his improved participation in practice this week, he seems like a good bet to be just fine for Sunday’s game. The bigger worry with Woodhead are the touches he will lose to Shane Vereen after the monster performance he had last week. Chandler Jones appears to be relatively healthy after he suffered a slight re-aggravation of his sprained ankle against the Texans. He was a full participant in practice Friday and appears to be ready to go. Expect him to have some limitation as it’s very difficult to play full strength with any sort of ankle sprain due to the drop off in stability around the ankle, but he should be productive in bursts. 

For the Ravens, Bernard Pierce is still dealing with a sprained knee and is officially listed as questionable. Word is he will play Sunday, but I can’t see how he’s going to be close to 100%. It seems like Pierce won’t be at full strength leading up to Sunday’s game, although all signs point to him suiting up and being the change of pace back that spells Ray Rice. Other than Pierce, the Ravens enter Sunday’s basically at full strength. 

This is tough game for me to predict. I think the Pats’ offense has a definite advantage over the Ravens’ aging defense, but it always seems like the Ravens give the Pats’ O-line and Tom Brady fits with their coverage packages and blitz schemes. I expect there to be some rough patches early for the Pats’ offense, but they will make adjustments throughout the course of the game. On the other side of the ball, I think the key will be the Pats’ ability to limit big downfield plays on the outside as well as bottling up Rice on screen passes and runs outside the tackles. I think the Pats make just enough plays on D and score a bit too much for Flacco and the Baltimore O to keep up with. I think the Ravens cover, but the Pats win. Patriots 31, Ravens 27

49ers (-4) vs Falcons: This game is a bit more clearcut in my book. In terms of injuries, John Abraham is officially listed as questionable, as he was a limited participant in practice on Friday. From my vantage point, I think this was a calculated decision to allow him some rest time and avoid re-injury at all costs. I think he’s healthier this week than he was last week, as he didn’t get to play in the 2nd half. As for the 49ers, the only lingering injury issue is Justin Smith, although he looked good last week and was well protected by that bulky brace around his elbow to stabilize that triceps injury. He looked like his disruptive self last week, occupying multiple blockers many times throughout the game, so expect the Niners’ defense to be just fine against the Falcons. 

I think this game boils down to how the Falcons handle the pressure the stout Niners’ defense throws at them all day; in particular, the decisions Matt Ryan makes on his feet and if he can stay away from turning the ball over. I think he’ll do a pretty good job, but I think the Niners’ defense and the dynamic play of Colin Kaepernick will be too much. The 49ers cover and win the game outright. 49ers 35, Falcons 24.

Did Gronk Come Back Too Soon?

I just wanted to quickly chime in on this discussion about whether Rob Gronkowski came back too soon and/or did the first fracture predispose him to re-fracturing. To answer the first question, he definitely did NOT come back too soon in terms of being cleared to play because that time frame is typically 6 weeks post surgery to repair a fracture. To clarify, this 6 week mark is typically when enough bone healing has occurred to clear someone to load through the bone again, not necessarily a fool proof timeline for when the bone is 100% healthy again. Even after 6 weeks, there is still risk for re-injury, especially for a big, physical NFL tight end who relies on his arms to catch/block/brace his fall. And once clearance is received from the MD to return, it’s on the athlete to let the training staff know how he feels and I can’t imagine Gronk would have been able to hide excruciating pain from the medical staff well enough to trick anyone. So I think the Pats did nothing wrong in terms of whether he was rushed back to play to soon, it was just a bad break.

The second question is whether this first fracture predisposed him to another fracture. Technically, once you suffer a fracture that requires hardware being implanted, the areas at the end of the hardware (the metal plate) become the weak points, which makes them more susceptible to injury. The main issue with Gronk’s re-fracture is that all of his body weight came crashing down on the involved forearm, which basically created a perfect storm.

At the end of the day, the more you injure a specific joint/muscle/area, the more likely you are to have it happen again. Think about the first time you sprain an ankle: it gets better and you stop worrying about it, but it always seems like a second sprain is just around the corner. In the long term, Gronk should be just fine and have no repercussions in prepping for the 2013 season. He’ll now have 8 months before the new season kicks off to get that forearm strong and healthy. This is not an injury that has any bearing on Gronk’s draft status for next season. He will still be worth a 2nd round pick and you should count your lucky stars if he falls any lower than pick 14-16 and snatch him up if you get the chance.

Quick Thoughts from the Divisional Round

  • The Pats losing Rob Gronkowski for the rest of the season is big, but probably not as big as you think. If you remember last year’s Super Bowl, he tried to play after suffering a high ankle sprain and was really more of a hindrance out there than a help. He just hasn’t been healthy in weeks and with the risk for re-injury always present, it’s better for his long term future to just sit and let that fractured forearm heal. Offensive is not where the Pats have problems anyways, so if the defense can continue to play very well, losing Gronk won’t be a back breaker.
  • Keep an eye on John Abraham and his sprained ankle. He didn’t play a full game yesterday and is clearly limited right now. Without him setting the edge and getting pressure on the QB, Russel Wilson had a field day running the ball, which just happens to be the strength of Colin Kaepernick and the Niners’ offense. If Abraham is just as limited this Sunday, it could be another field day for another running QB against the Falcons. Abraham will play, but just keep that in mind moving forward
  • Justin Smith made it all the way through the Niners’ victory over the Packers on Saturday unscathed, so expect him to slowly get stronger and stronger as things move forward. With muscular tears, it’s hard to say that he’s out of the woods because one wrong move can cause excruciating pain or re-tear the muscle in question. So keep an eye on him during the week and expect him to be limited.
  • I have to say, I’m disappointed in the Broncos not getting to the AFC championship, if only because I was looking forward to a blast from the past Brady-Manning showdown, specifically because Manning has the most recent upper hand on Brady in playoff contests. In a rivalry that was once dominated by Brady and the Pats, Manning knocked out the Pats in 2006 on his way to his first Super Bowl win, which I’m sure the Pats remember well (Remember Belichick’s 4th and 2 from their own 20-something yard line in the 4th?). But this Pats-Ravens rivalry is heating up VERY quickly and should be a war. My early thought is that the Pats defense is the key to this game, as they can’t allow Joe Flacco and the Ravens’ offense early momentum and confidence. This game should be a nail-biter.

Bouncing Back From an ACL Tear

rg3acl

(This article was published originally 3 years ago, some of the content has been changed from it’s previous publication)

If we learned anything from Week 16 and the Wild Card round of the playoffs, it’s that watching someone tear their ACL remains one of the most gruesome things to experience, whether it’s in person or while watching TV. Sitting at a friend’s house watching the 49ers/Seahawks game during Week 16, I knew it the second I saw it that Mario Manningham tore his ACL. I actually remember saying that I thought he tore both his ACL and MCL, mainly based on how much his knee dove in when he got his foot caught underneath his body. Same goes with watching RGIII this past weekend against the Seahawks, although initial reports say that he only has partial tears of the ACL and MCL. Maybe short of a broken bone, nothing makes me cringe more than seeing an athlete tear his ACL, partly because it almost always seems like they KNOW they just tore their ACL and that the next year of their lives just changed in an instant. Despite the improvements in surgical intervention and rehabilitation, recovery post-ACL reconstruction remains both tricky to predict and a long, arduous process.

The point of this post today is not to point out what we already know: ACL tears are bad. But it’s to give you some insight into why exactly this small bundle of collagen fibers plays such a crucial role in an athlete’s function and what goes into the rehab process following this gruesome injury.

First question we have to answer: What is the ACL? Essentially, and very simply, the Anterior Cruciate Ligament (ACL) stops the tibia (shin bone) from gliding anteriorly (forward, towards the front of the body) on the femur (thigh bone). The significance of this knee ligament is that it provides the stability of the knee during movements such as planting-and-pushing-off, stopping quickly on a dime, cutting, and decelerating during a run/sprint. When you take this ligament away from a football player, it’s essentially taking away their burst, change of direction, and ability to accelerate/decelerate all in one pop (literally). Check out this diagram to get a visual of everything I just rambled on about:

ACL_tear

Now that we understand the function of the ACL, our next question to answer is this: How does a person tear an ACL? Typically, the most common mechanism of injury (MOI) for an ACL tear is a twisting motion occurring at the knee while the foot is planted on the ground. This can happen with or without another player/person present, as it is quite common for an athlete to tear their ACL with no one anywhere near them (RGIII is a perfect example). What typically happens is the torsion that’s imparted on the knee places maximal strain on the ACL itself, and without the sufficient supporting joint and muscular strength to take on this force, the ACL overstretches. And with the right amount of excessive force, this leads to a partial or full tear of the ligament. Also, if the movement in question or the blow to the knee causes the knee to dive in enough, this is very commonly how people tear both the ACL and the Medial Collateral Ligament (MCL) and, potentially, medial meniscus at the same time. The MCL is the ligament that stops the knee from collapsing in when someone hits your knee from the outside. The combo platter of an ACL and MCL is typically a bit more tricky to surgically repair and rehab due to the addition of even more instability at the knee. Always remember, the more structures involved, the more difficult the rehab is.

Another common MOI with ACL tears is excessive knee hyperextension. When this happens, the femur can glide posteriorly (to the back) on a stable tibia when the foot is planted to the ground, which causes relative excessive anterior tibial motion. Think about what we said was the function of the ACL, stopping the tibia from moving anteriorly (forward) on the femur. Well, if you keep the tibia (shin bone) stable and move the femur posteriorly, it basically causes the same movement, except the femur is doing all the moving. This can also put strain on the Posterior Cruciate Ligament (PCL), which stops the tibia from moving posterior on the femur.

Ok, so we’ve gone over what the ACL is and how people tear their ACLs. Now, what goes into rehabbing this important ligament? Post surgery, the most important thing to regain is range of motion (ROM). Since a person is typically placed in a brace of some sorts (most of the time, depends on the doc) to help protect the new ligament, the knee becomes very stiff and does not move very well once the rehab process begins.

[Quick side note before we move on: When reconstructing the ACL, there are typically 3 options when deciding what type of graft to use: Your own patellar tendon, Your own hamstring tendon, or an ACL from a cadaver. Typically, cadaver grafts provide a good combination of quick recovery and great results long term, but there’s always the chance of rejection because you’re putting foreign tissue in your body and there’s increasing shift away from this now as more evidence becomes available. Patellar tendon grafts typically are super stable, but take a bit longer to heal because you’re using a tendon instead of a ligament, as tendons are not as pliable as ligaments. Also, taking a chunk of your patellar tendon can weaken your quadriceps muscle group significantly, as the patellar tendon attaches the quads to the tibia. Hamstring grafts are the last of the three options and allow the athlete to get back a bit faster than the patellar tendon choice and is arguably gaining more popularity now compared to 5-10 years ago]

While concurrently working on range of motion, initial strengthening of the quads, hamstrings, and gluts are in order, usually beginning with isometric strengthening (activating musculature without movement). In addition, it’s imperative to work on surgical scar mobility in order to allow the surrounding tissue to maintain its mobility and properly slide/glide on each other during motion.

The first phase of the rehab process is predicated on achieving 3 major milestones: 1- Regain proper quad muscle activation; 2-Decrease and minimize post-operative swelling; 3- Regain full range of motion, particularly full knee extension (straightening out the knee). Achievement of these three milestones is crucial before progressing to the next stage of rehab.

Following these initial phases in addition to the athlete being cleared by their orthopaedic surgeon, there’s a progression from isometric strengthening to isotonic, which involves moving resistance as muscle length changes. This progresses from mat exercises to sitting exercises to standing exercises, all based on achieving milestones before moving on to the next phase.

Once this phase is reached, we move on to dynamic movements, in straight lines first, then adding lateral and diagonal motions to help rebuild stability around the knee. This goes on until the individual is ready to do sport-specific exercises, which is the last step before return to play.

Last important question we need to answer is what is the prognosis for recovery from this terrible injury? This varies depending on the individual and whether multiple structures were involved, but as Adrian Peterson showed us, timetables can be thrown out the window when it comes to world class athletes. BUT, in general, prognosis for return to sport can be anywhere from 6 months to 12 months, depending on complications, past injury history, and response to rehabilitation. But as you’ve probably heard many times, a player in any sport is typically not back to their “prior level of function” until the second year following reconstruction.

This is by no means a set rule for all cases, but it takes time for an athlete to feel comfortable back on the field again, competing at the highest levels, without thinking about how to move and whether their knee with hold up to these enormous demands placed on it. One of the more difficult things for an elite athlete following this type of injury is getting back to moving instinctively, which is where a lot of the variability in return to sport comes from. Some get this back faster than others.

What does this mean for someone like Breshad Perriman. According to Ian Rappaport from NFL.com, he saw Dr. James Andrews today to determine the next step in his recovery process

This is the tricky part of suffering a partial tear vs a full tear. With partial tears, due diligence needs to be performed in order to determine the severity and extent of the damage before jumping into making a decision on reconstruction vs conservative rehabilitation. The likelihood of Perriman going the conservative route, in my opinion, is slim. If he does, they’d take the rehab process on a week to week basis, determine his response to treatment, and ultimately see if he can get back on the field and perform at a high level while they give the ligament time to heal.

However, this road could still ultimately lead to reconstruction if conservative rehabilitation does not get the job done, which will end up costing him time on the back side. The one positive from attempting to rehab first would be that Perriman would be extremely strong and mobile going into the surgery, as PREhab has been shown to improve outcomes post-operatively. Regardless, and very unfortunately, I don’t think we’re seeing Perriman at all this year, which means we’re looking increased involvement of both Kamar Aiken and Mike Wallace this season barring a free agent signing.

Thanks for reading kids! Much more to come to help you get ready for the 2016-17 season.

Full Week 17 Injury Report

I’ll refer you to my post at FFLockerRoom again for my Week 17 injury post.

http://fflockerroom.com/2012/12/29/fantasy-football-week-17-injury-update-t-richgronkmjd/

And just FYI, I’ll update the blog soon with a post about the recent rash of ACL injuries both during Week 16 and over the last few seasons. Hopefully it’ll give some insight into why the ACL is so important and why it’s so difficult to come back from.

 

Gronk Limited, Jordy Probable, AP a Full Go

TE Rob Gronkowski will play against the Dolphins on Sunday, but it’s being reported that he’ll only be out there in a limited basis. Consider this his “test run” for the playoffs, his way of showing the training and coaching staffs that he is healthy and ready to go. That’s great news for Pats fans, not so great news for Gronk fantasy owners. He will not play enough to be a significant factor for you, and with a return from fracture, it’s hard to predict how he’ll respond to his first in game contact. Stick with your Gronk replacement for one more week.

Jordy Nelson is expected to make his return tomorrow, as this situation is semi-similar to Gronk’s in that I’m sure the training staff wants to see if his hamstring has healed sufficiently for him to run, cut, and accelerate/decelerate at game speed. With Randall Cobb expected to miss Sunday’s game, Nelson’s stock should be sky high. Get him in your lineup.

Adrian Peterson is rested and ready to go. Although he’s dealing with abdomen and groin strains,  they are considered mild and will not threaten his playing. With Minnesota in a “win and get in” playoff scenario, expect AP to hold nothing back and make a run at Eric Dickerson’s NFL single season rushing record. He’s good to go.

Set That Lineup: Week 15 Injury Updates

Here’s my link to this week’s injured folks: http://fflockerroom.com/2012/12/15/fantasy-football-week-15-injury-report/

Two extra thoughts: RG3 not playing is huge. I hope RG3 owner’s treated him like they did Michael Vick, as the running QB who is also slim in stature is always a dangerous combination. I think Kirk Cousins will be adequate, but I can’t imagine he puts up the numbers (or anything near them) that RG3 does. Also, Cousins did seem to look Pierre Garcon’s way a few times in his limited snaps, and veteran wideouts are very valuable to young QBs. Look for Garcon to benefit either way.

Also, Roddy White is looking like he’s not going to play this week. There’s still a chance he suits up, so keep an eye on the situation tomorrow morning, but with him not practicing Thursday or Friday, it’s hard for me to imagine that he’d be ready to go out there and be anywhere near 100% with so much time taken off this week. I’d look elsewhere to be on the safe side, but monitor the situation tomorrow AM.